Auto chess in the operating room

Chapter 148 Contrast-enhanced Ultrasound and Enhanced CT
The so-called contrast-enhanced ultrasound requires the use of GE Logiq E 9 color Doppler ultrasound diagnostic instrument equipped with real-time imaging function, and there is only one instrument for the entire general surgery department, so many patients are waiting to use it. This kind of minor surgery is not used.

As for enhanced CT, GE Light Speed ​​VCT 64-slice spiral CT should be used. From the perspective of effect, these two examination methods have a good role in differentiating gallbladder sediment-like stones and thick-walled gallbladder benign lesions.

Compared with conventional ultrasound, CEUS can provide more information for differential diagnosis because it can dynamically display the blood perfusion and microcirculation characteristics in the lesion in real time.

The effect is good, but the cost is naturally high. Like Hecheng No. [-] Hospital, double-enhanced surgery is rarely needed.

This is the hospital in the capital city of Hangzhou, and only professors are used to using double-enhanced films.

"The patient's condition has actually been diagnosed through ordinary color Doppler ultrasound and CT. I don't think it is necessary to do double enhancement, which is not very meaningful. Moreover, to be honest, the operation is going to be tomorrow, and today's schedule may not be in time. .”

Yan Ruoyun called Tang Qichen directly to communicate.

"Doctor Yan, this was specifically proposed by Professor Huang. I think we still respect Professor Huang's opinion."

How could Tang Qichen dare to say no to Professor Huang? He had devoted a lot of energy to this operation, and he didn't want to make Professor Huang's team unhappy because of these things.

"OK then."

Yan Ruoyun finally compromised. After all, given Professor Huang's status, he could only try his best to cooperate with his request.

After putting down the phone, Yan Ruoyun started arranging contrast-enhanced ultrasound and enhanced CT.

It's just that this temporary arrangement increases the examination, and it is extremely demanding for contrast-enhanced ultrasound and enhanced CT. It is simply impossible to do so quickly.

The only way is to let the doctor who does the examination get off work overtime to help after work through personal relationship.

However, Yan Ruoyun really didn't have any suitable people in the CT room. Moreover, the overtime inspections were usually done by young people, and he rarely had contact with him at his age.

"Tang Lou, do you have any friends in the CT room who can help with the examination."

Of course, Yan Ruoyun didn't have high hopes. After all, Tang Lou was a training doctor and had only rotated in the general surgery department, so he asked casually.

"No, but I can ask for help."

"Okay, then you can ask first, and I will think of a way."

Yan Ruoyun walked away while holding the phone, flipping through the address book.

The first thing Tanglou thought of was naturally Cheng Sisi, and he sent a WeChat message.

Soon Cheng Sisi came back: "Senior brother Yang Ming is currently rotating in the CT room, do you want me to ask him for you, can I work overtime after work to help you fix it."

Before Tang Lou could reply, after a while, Cheng Sisi sent a second WeChat message:
"It's done! Senior Brother Yang Ming said that he will work overtime today, so you can go there at 06:30 tonight."

"Okay, okay, then thank Yang Ming for me."

Tang Lou didn't expect it to be resolved so quickly, and when he thought that the other party was Yang Ming, he felt a strange sense of fate.

"Don't you thank me. A disappointed expression."

Soon, Cheng Sisi sent another WeChat message.

"Take you to dinner on the weekend. Express my thanks to you."

Tang Lou immediately went back to the past.

"Yeah, that's pretty much it. Three drooling faces."

Tang Lou quickly called Yan Ruoyun.Hearing that Tang Lou had completed the inspection, he was naturally overjoyed.

"Young people today are amazing."

After Yan Ruoyun put down the phone, he naturally made up his mind a lot, and thought of the importance that Director Cheng and Director Shen attached to Tang Lou, and this will solve the CT examination that caused him a headache.

This tenement building made him a little confused. It seemed that he couldn't just treat him as a talented young man in the future.

When Lai Meiyun's operation was proceeding step by step.

Hu Jie, whose cholecystitis caused myocardial infarction before, was sent back to the General Surgery Department from the Cardiothoracic Surgery Department after treatment, and continued to undergo the next cholecystectomy.

And very coincidentally, Hu Jie was assigned to Lin Dong's group, because the patient had just been rescued and had acute myocardial infarction.

So for this cholecystectomy, Lin Dong invited Yan Ruoyun and Qingping to prepare a small consultation together.

As interns, Ye Kai and Hong Guan were of course responsible for projection and meeting preparation, and were not qualified to conduct consultation discussions.

So, before the consultation started, after all the staff arrived, they were both very surprised and a little unconvinced when they saw Tang Lou was also present.

However, seeing Tang Lou sitting down to participate in the meeting, Yan Ruoyun and Qingping didn't think there was anything wrong.

Even the two senior attending doctors had no objections, and Lin Dong, as a resident doctor, certainly would not question Tang Lou's attendance.

As the organizer of the meeting, Lin Dong released the patient's information as soon as everyone arrived, and at the same time turned on the projection to introduce Hu Jie's situation in detail.

Looking at the information, Tang Lou was also slightly taken aback, what a coincidence.

"I diagnosed this patient together with Ma En. At that time, I asked her to have an electrocardiogram and cardiac color Doppler ultrasound. However, the patient was so uncooperative that acute myocardial infarction was caused during the fluid rehydration process."

Tang Lou reported the previous incident to Yan Ruoyun, Qingping and others.

"That's disgusting. It's difficult for such a patient to file a complaint if he doesn't cooperate with the treatment."

After Lin Dong heard this, his brows were already furrowed, and he was a little reluctant to undergo the operation.

"Since the patient has just been rescued, the risk of cholecystectomy is still very high. In view of the behavior of the patient and his family, it is necessary to communicate with them well before the operation. If the patient and his family continue to mess around, then I suggest that they be directly transferred to the hospital for treatment. Our department does not accept it."

Yan Ruoyun, as an old Jianghu, of course, has already analyzed it from Tang Lou's introduction. Such patients and their families are the most disgusting to doctors.

You have done a lot of things and assumed a lot of responsibilities, but the patients and their families not only don't appreciate it, but also beat them back, and you may even make a big fuss.

Reports of family members stabbing and stabbing doctors to death due to medical disputes are not uncommon.Therefore, treating some garbage people is not worth the candle.

"Dr. Yan is right. We first formulate the operation plan and communicate with the patient and family members. In view of the special situation of the patient, the possibility of danger during the operation is very high, so we must ask them to sign a disclaimer in advance, otherwise something will happen later. Accidents, in their character, are very bad for us."

Qing Ping also spoke at the side. All doctors work together to deal with such bad patients.

"For cholecystectomy, the traditional method is laparotomy, which is obviously not suitable for this patient. There is also four-port laparoscopic cholecystectomy, but due to the poor physical condition of the patient, he has repeated cholecystitis all year round. In addition, just after first aid, there may be deterioration and new problems, and further diagnosis cannot be confirmed. Only in the operation can the real diagnosis be made. Therefore, the difficulty and risk are very high."

Lin Dong put forward his own opinion.

Both Yan Ruoyun and Qingping nodded slightly, lost in thought. If they were ordinary patients, they would naturally be willing to try and take risks.

But now it is obvious that for this patient and his family members, if there is an accident during the operation, there will be a great possibility of medical disputes in the future.

Yan Ruoyun pondered for a few more seconds. After all, the patient was assigned to Lin Dong. As his direct leader, of course he had to make the decision for Lin Dong: "Lin Dong, Dr. Qing and I agree with you. Hidden dangers of medical disputes for patients and their families. If you are sure, then perform an operation; if you are not willing, then we recommend that the patient be transferred.”

Lin Dong breathed a sigh of relief after hearing this. To be honest, of course he didn't want to have surgery.

This kind of patient and family does not deserve it.

(End of this chapter)